Audiology and Neuro-Otology最新文献

Introduction: To date, no study has reported the various otologic conditions associated with coronavirus disease 2019 (COVID-19) using population-based design. The aim of this study was to investigate the incidence and risk of audio-vestibular disorders (benign paroxysmal positional vertigo, sudden sensorineural hearing loss, Meniere's disease, vestibular neuritis, and tinnitus) increasing after COVID-19 infection.

Methods: This retrospective population-based study was conducted using the National Health Insurance Service (NHIS)-COVID-19 cohort database of South Korea. We identified participants in the COVID-19 group using real-time reverse transcription-polymerase chain reaction tests. A matched cohort without COVID-19 was randomly selected in a 1:1 ratio. Benign paroxysmal positional vertigo, sudden sensorineural hearing loss, Meniere's disease, vestibular neuritis, and tinnitus were defined using diagnostic, medication, and procedure codes. The incidence and risk of these disorders were assessed in both groups using univariate and multivariate Cox proportional hazard analyses.

Results: In total, 4,976,589 COVID-19 patients and an equivalent number of matched non-infected controls were analyzed. COVID-19 patients faced an increased risk of developing benign paroxysmal positional vertigo, sudden sensorineural hearing loss, vestibular neuritis, and tinnitus compared to controls in univariate and multivariate Cox hazard analyses. COVID patients were at an increased risk of Meniere's disease in the univariate analysis; however, the risk of Meniere's disease after COVID-19 did not reach statistical significance in the multivariate analysis.

Conclusion: COVID-19 infection may increase the risk of benign paroxysmal positional vertigo, sudden sensorineural hearing loss, vestibular neuritis, and tinnitus.

Introduction: Performing two tasks simultaneously may present various challenges for the human cognitive system. This study investigates how concurrent cognitive tasks impact the performance of the functional head impulse test (fHIT) in healthy adults. It was hypothesized that adding a cognitive load during fHIT would reduce the test's scores due to shared attentional resources.

Method: Twenty-seven participants completed the functional head impulse test (fHIT) and verbal fluency tests simultaneously. The study was designed in three stages: (1) recording fHIT results without any cognitive task, (2) completing the categorical fluency test and fHIT concurrently, and (3) administering the phonemic fluency test and fHIT simultaneously, with results recorded.

Results: Significant differences were observed in fHIT performance with and without additional cognitive tasks. Categorical tasks (e.g., animal and furniture categories) and phonemic tasks (e.g., words starting with "K," "A," or "S") impacted fHIT results, with notable performance reductions.

Conclusion: This study demonstrates that dual-task scenarios involving cognitive and vestibular demands adversely affect fHIT performance. The findings underscore the importance of attentional capacity in tasks requiring simultaneous cognitive and visual-oculomotor processing. These insights could guide future clinical applications in assessing and rehabilitating vestibular and cognitive deficits.

Introduction: Mal de debarquement syndrome (MdDS) is a rare and poorly understood clinical entity defined as a persistent sensation of rocking and swaying that can severely affect the quality of life. To date, the treatment options are very limited. Even though vestibular rehabilitation (VR) efficacy following peripheral vestibular lesion is well-documented, little is known about its influence on MdDS. The objective of the study was to explore the influence of traditional VR program on postural control in a patient diagnosed with MdDS.

Methods: We assessed 3 different participants: 1 healthy control; 1 participant with identified peripheral vestibular impairment (VI); 1 participant diagnosed with MdDS. Postural control was assessed using a force plate (AMTI, Accusway). Participants were assessed following the modified Clinical Test Sensory Integration Balance protocol (mCTSIB, eyes open on firm surface/eyes closed on firm surface/eyes open on foam/eyes closed on foam). The raw data were exported and analyzed in a custom-made Matlab script (Matlab R2020a). We retrieved the center of pressure velocity in both anterior-posterior and mediolateral directions and performed an analysis of the frequency content using Daubechies wavelet of order 4 with 6 levels of decomposition. Protocol VI and MdDS patients performed a 4-week VR program. Postural control, using a force plate, and Dizziness Handicap Inventory (DHI) were assessed before and after the VR program. Healthy control was assessed twice separated by 1 week without any specific intervention.

Results: VI participant showed clear improvement on DHI and sway velocity on condition eyes closed with foam. Accordingly, a reduction of energy content within frequency bands (0.39-0.78 Hz and 0.78-1.56 Hz) was observed post-rehabilitation for VI participant in both conditions with foam. Interestingly, MdDS participant demonstrated a reduction in sway velocity in most of the conditions but the frequency content was not modified by VR and was comparable to healthy control. Accordingly, the DHI of the MdDS participant failed to demonstrate any difference following VR.

Conclusion: The results of the present study question the use of VR as an efficient treatment option for MdDS. Future studies must recruit a larger sample size and focus on the relationship between illusion of movement and postural characteristics such as sway velocity.

Introduction: Aging deteriorates peripheral and central auditory structures and functions. In elders, for an accurate audiological evaluation, it is important to explore beyond the cochlear receptor. Audiograms provide an estimation of hearing thresholds, while the amplitudes and latencies of supra-threshold auditory brainstem response (ABR) can offer noninvasive measures of the auditory pathways functioning. Regarding ABR, in young populations, level-specific chirp (LS CE-chirp) stimulus has been proposed as an alternative synchronizing method to obtain larger ABR responses than those evoked by clicks. However, the supra-threshold characteristics of chirp evoked ABR, and their association to hearing thresholds is relatively unknown in the elderly. The aim of this study was to evaluate supra-threshold LS CE-chirp ABRs in an aged population by comparing their features with click ABRs, and evaluating their relationship with audiometric hearing thresholds.

Methods: We carried out a cross-sectional study to characterize the hearing of 125 adults aged over 65 years. We determined the audiometric hearing thresholds and supra-threshold ABRs elicited by LS CE-chirp and click stimuli at 80 dB nHL. We evaluated associations by means of partial correlations and covariate adjustment. We performed specific frequencies' analysis and subgroup analysis per hearing level.

Results: Wave V responses had significantly shorter latencies and larger amplitudes when elicited by LS CE-chirp as compared to click-evoked responses. Audiometric hearing thresholds correlated with age, but ABR characteristics did not. We found mild correlations between hearing thresholds and ABR characteristics, predominantly at higher frequencies and with chirp. We found scarce evidence of correlation between ABR characteristics and the average of behavioral hearing thresholds between 0.5 to 4 kHz (0.5-4 kHz PTA). After subgroup analysis according to the hearing level, no stronger or more significant correlations were found between ABR characteristics and 0.5-4 kHz PTA.

Discussion: In this study, we found that supra-threshold LS CE-chirp ABR presented some of the previously described similitudes and differences with supra-threshold click ABR in younger populations. Although, the average amplitude and latency of wave V evoked by LS CE-chirp were larger and faster than those evoked by clicks, these results should be taken with caution at the individual level, and further studies are required to state that LS CE-chirp ABRs are better than click ABRs in elders for clinical evaluations. We did not find consistent associations between hearing thresholds and supra-threshold wave V features, suggesting that these measures should be considered independently in the elderly.

Introduction: The mechanism of non-osseous bone conduction pathways, involving the intracranial contents (ICC) of the skull, is still not well understood. This study aimed to investigate the influence of the ICC on the skull bone wave propagation, including dependence on stimulation location and coupling.

Methods: Three Thiel-embalmed whole-head cadaver specimens were studied before and after the removal of the ICC. Stimulation was via the electromagnetic actuators from commercial bone conduction hearing aids. Osseous pathways were sequentially activated by mastoid, forehead, and bone-anchored hearing aid location stimulation via a 5-Newton steel headband or percutaneously implanted screw. Non-osseous pathways were activated by stimulation on the eye and dura via a 5-Newton steel headband and a custom-made pneumatic holder, respectively. Under each test condition, the 3D motion of the superior skull bone was monitored at ∼200 points.

Results: The averaged response of the skull surface showed limited differences due to the removal of the ICC. In some isolated cases, the modal pattern on the skull surface showed a trend for an upshift (∼1/2 octave) in the observed natural frequencies for drained heads. This was also consistent with an observed trend for an upshift in the transition frequency in the estimated deformation across the lateral surfaces of the temporal bones. Such changes were consistent with the expected reduction in mass and damping due to the absence of the ICC.

Conclusion: Overall, the ICC affect to a limited extent the motion of the skull bone, with a limited trend for a reduction of its natural frequencies.

Introduction: Surgical treatment of Ménière's disease (MD) and deafness aims to treat vertigo and hearing disabilities. Current treatment options like labyrinthectomy and cochlear implantation (CI) have shown acceptable results but are destructive. Less destructive procedures, like the occlusion of the lateral semicircular canal and endolymphatic sac surgery, have been shown to be successful in vertigo control. The combination of both procedures with CI has not been investigated; therefore the objective of this study was to investigate the outcome of this combination in patients with single-sided MD and moderately severe to complete sensorineural hearing loss.

Methods: In this retrospective study, 10 patients with single-sided MD and moderately severe to complete sensorineural hearing loss were included. In all of them, a single-staged surgery, which consisted of CI, endolymphatic sac surgery, and occlusion of the lateral semicircular canal, was performed. The surgery was performed after a failed conservative therapy trial. The clinical outcome was evaluated by the Dizziness Handicap Inventory (DHI) and audiological tests. These were assessed preoperatively, 3 and 6 months after surgery. An MRI with a hydrops sequence was performed to support the clinical diagnosis.

Results: After the combined surgery, the mean DHI testing improved significantly from 71 to 30. Mean audiological monosyllabic speech testing outcome with the cochlea implant was 65% at 65 dB. The residual hearing of 2 patients could be preserved after the surgical procedure.

Conclusion: The combination of occlusion of the lateral semicircular canal, endolymphatic sac surgery, and CI is an efficient low traumatic treatment for patients with a single-sided MD and moderately severe to complete sensorineural hearing loss.

Introduction: Several studies have reported that the number of patients with Bell's palsy varied significantly by month and season. However, few studies have reported the monthly variation in Bell's palsy based on the whole population. We investigated the monthly variation in Bell's palsy in Korea during a long-term period based on whole population data.

Methods: This retrospective study used the data of the National Health Insurance Service of Korea, which included the entire Korean population from 2008 to 2020. The monthly incidence of Bell's palsy per 100,000 was evaluated in total and according to sex, age, and residence.

Results: The total average monthly incidence differed significantly by month, with the highest observed in January (9.1 per 100,000) and the lowest in June (7.7 per 100,000) (p < 0.001). The average monthly incidence according to sex, age, and residence also varied significantly by month, with most of the highest values noted in January and the lowest in June.

Conclusion: There was significant monthly variation in the incidence of Bell's palsy, with the highest in January during the winter and the lowest in June during the summer, based on whole population data over a long-term period in Korea.

Introduction: The effect of chronic kidney disease (CKD) on hearing is well documented in the literature. Several studies have investigated the effect of hemodialysis on the peripheral auditory system among individuals with CKD. However, studies investigating the effect of hemodialysis on speech perception and auditory processing abilities are limited. The present study investigated the effect of hemodialysis on few auditory processing abilities and speech perception in noise among adults with CKD.

Methods: A total of 25 adults with CKD undergoing hemodialysis regularly participated in the study. Spectral ripple discrimination threshold (SRDT), gap detection threshold (GDT), amplitude-modulation detection threshold (AMDT), and speech recognition threshold in noise (SRTn) were measured before and after hemodialysis. Paired samples "t" test was carried out to investigate the effect of hemodialysis on thresholds.

Results: Results showed a significant improvement for SRDT, GDT, AMDT, and SRTn after hemodialysis among individuals with CKD.

Discussion: Hemodialysis showed a positive effect on speech perception in noise and auditory processing abilities among individuals with CKD.

Introduction: Hearing loss is a major global public health issue that negatively impacts quality of life, communication, cognition, social participation, and mental health. The cochlear implant (CI) is the most efficacious treatment for severe-to-profound sensorineural hearing loss. However, variability in outcomes remains high among CI users. Our previous research demonstrated that the existing subjective methodology of CI programming does not consistently produce optimal stimulation for speech perception, thereby limiting the potential for CI users to derive the maximum device benefit to achieve their peak potential. We demonstrated the benefit of utilising the objective method of measuring auditory-evoked cortical responses to speech stimuli as a reliable tool to guide and verify CI programming and, in turn, significantly improve speech perception performance. The present study was designed to investigate the impact of patient- and device-specific factors on the application of acoustically-evoked cortical auditory-evoked potential (aCAEP) measures as an objective clinical tool to verify CI mapping in adult CI users with bilateral deafness (BD).

Methods: aCAEP responses were elicited using binaural peripheral auditory stimulation for four speech tokens (/m/, /g/, /t/, and /s/) and recorded by HEARLab™ software in adult BD CI users. Participants were classified into groups according to subjective or objective CI mapping procedures to elicit present aCAEP responses to all four speech tokens. The impact of patient- and device-specific factors on the presence of aCAEP responses and speech perception was investigated between participant groups.

Results: Participants were categorised based on the presence or absence of the P1-N1-P2 aCAEP response to speech tokens. Out of the total cohort of adult CI users (n = 132), 63 participants demonstrated present responses pre-optimisation, 37 participants exhibited present responses post-optimisation, and the remaining 32 participants either showed an absent response for at least one speech token post-optimisation or did not accept the optimised CI map adjustments. Overall, no significant correlation was shown between patient and device-specific factors and the presence of aCAEP responses or speech perception scores.

Conclusion: This study reinforces that aCAEP measures offer an objective, non-invasive approach to verify CI mapping, irrespective of patient or device factors. These findings further our understanding of the importance of personalised CI rehabilitation through CI mapping to minimise the degree of speech perception variation post-CI and allow all CI users to achieve maximum device benefit.

Introduction: The aim of the study was to investigate differences in the intra- and inter-network functional connectivity (FC) of the brain using resting-state functional magnetic resonance imaging (rs-fMRI) in patients with tinnitus, with (T + H) or without hearing loss (T).

Methods: We performed rs-fMRI on 82 participants (21 T, 32 T + H, and 29 healthy controls). An independent component analysis (ICA) was performed to obtain the resting-state networks (RSNs) and calculate the differences in FC. Moreover, we investigated the relationships between networks using functional network connectivity analysis.

Results: We identified nine major RSNs, including the auditory network; default mode network; executive control network (ECN), including the right frontoparietal network and left frontoparietal network (LFPN); somatomotor network (SMN); dorsal attention network; ventral attention network; salience network (SN); and visual network (VN). These RSNs were extracted in all groups using ICA. Compared with that in the control group, we observed reduced FC between the LFPN and VN in the T group and between the LFPN and SN in the T + H group. The inter-network connectivity analysis revealed decreased network interactions in the SMN (IC 22)-ECN (IC 2), SMN (IC 22)-VN (IC 8), and VN (IC 14)-SN (IC 3) connections in the T + H group, compared with the healthy control group. Furthermore, we observed significantly decreased network interactions in the SMN (IC 22)-VN (IC 8) in the T group.

Conclusions: Our results indicated abnormalities within the brain networks of the T and T + H groups, including the SMN, ECN, and VN, compared with the control group. Furthermore, both T and T + H groups demonstrated reduced FC between the LFPN, VN, and SMN. There were no significant differences between the T and the T + H groups. Furthermore, we observed reduced FC between the right olfactory cortex and the orbital part of the right middle frontal gyrus, right precentral gyrus, left dorsolateral superior frontal gyrus, and right triangular part of the inferior frontal gyrus within the T and T + H groups. Thus, disruptions in brain regions responsible for attention, stimulus monitoring, and auditory orientation contribute to tinnitus generation.